2/2 Molly - Feedback if you have a moment please

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Michele&Molly

Michele&Molly

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First off i'd like to apologize for my absence on the boards. For those of you who don't know, my otherwise healthy 38 year old husband had a grand mal seizure on Wednesday night. While he is doing great now and all the tests came back sparkling (today! : ) , we are still trying to deal with the repercussions - inability to drive for example. Anyway, please accept my apology (and for those who believe this is not the place for extraneous stuff - simply don't read my posts - that easy).

With everything else going on - Molly was temporarily placed on the proverbial back burner. And i mean that only in the sense that i stopped freakin' about her for a few days to freak about the dh but she was/is still receiving food, lovin's, tests, and shots consistently.

Would you mind, only if you have the time, eye balling her numbers? While they seem slightly better, they are still pretty horrible! Also, is there an explanation that I’m not seeing, for a +11 of 387 and then a pmps of 268 this evening?

Your comments, suggestions, etc. are appreciated. -M
 
Glad Will is doing better and that tests had good news today!

I see you're feeding her at +3 now. Reason? I have always fed Gandalf after shot, then he can nibble if he wants and his feeder goes off around +5 and he can eat what he wants and nibble on the rest later. He's a grazer, so this works for him. I know you said you began waiting till +12 to feed all your cats, so is Molly getting food then too and more at +3?

Seems like something has changed, 5 months ago she did pretty good on 2U. I am still curious about what I understood to be weight gain for her over how long? With those kinds of numbers she should be losing weight, not gaining it. Can you get weights on her on a reliable scale on the same day a week apart to compare? If she is truly gaining weight with 300s to 400s, something is amiss.

As for the +11 387 to 268 an hour later, it could be from lack of food and/or late nadir.

Just covering all the bases again, as I know you have a lot going on, but I get suspicious of infections when doses which previously worked, stop working. If you can manage it, blood work showing WBC count might reveal something.
 
I'm still curious about the possibility of acromegaly given the weight gain. Read through the information on High Dose group about Acro - 50 males/19 females are recorded here, so it should not be considered a male only condition.

Please read the main informational post here: viewtopic.php?f=12&t=375

No Molly's not on a high dose, but after reading that the hormone levels can fluctuate, I can see that a cat might do fairly well on lower doses for a while, then become difficult to control at those doses. And weight gain is also a symptom.

I think it's worth doing some reading and seeing if any of the other symptoms ring a bell.
 
(((Michele))) You are sure going through a lot right now. Been thinking about you and Will.

I do agree with Vicky about seeing if there might be something else going on. How new is the insulin? Any change it got frozen in the fridge or something? Anything else change? Is someone building near you causing loud noises? (I actually asked that once and the person said, "OMG, yes!" So you never know.

While you figure that stuff out, maybe raise her another .25u? It did look like she was going to do ok on a dose reduction back when she went from 2u to 1.75u, but that is not holding now. At least you are getting some yellow PSs lately.
 
Michele,

Can DH do a mini curve today or tomorrow? Every 2 to 3 hours?

That +11 of 380's and the +12 of 260's is strange to me...why the fast drop? I'd like to see what's happening through the whole cycle before a dose change is made. She has been there long enough to settle and get a true picture of what's what.

No dose suggestions form me until I see a curve- BIGGER picture ;-)
 
Thanks for the feedback all - i appreciate it.

I did some reading about acro-kitties and it's def. something to have the vet look into. It is concerning to me that she appears to be getting fatter (and fatter) given her high numbers as of late. I weighed her 2 weeks ago and will weigh her again tomorrow morning. Anxious to see what it is.

Yes Vicky, Molly is fed at 12/12 and +3 in the eve. before i go to bed. Without that +3 feeding, the cats (mostly civvies) keep us up all night.

Going to increase the dose tomorrow morning to 2.5 and have W (the dh) test her during the day (or atleast get me the +8).

Thanks again you guys for the feedback as well as the well wishes!!
 
HI Michele,

I wish you could do the curve BEFORE you change the dose....It would be nice to see what is going on between all those numbers and THEN make an informed dose decision.

We could be missing some vital info- she may not need an increase or maybe not need that much of an increase or may need a decrease.

We might see that somewhere in the day she plummetsa which gives rise to the higher numbers.

After so much settle time on one dose- that would be an ideal time ot run a curve and get a true picture.

In my experience with PK, the day of the dose change- the curve is pretty meaningless unless you are monitoring for hypo.

Just MHO, of course.
 
Please, someone give Molly the textbook on diabetes - quickl

Where to start?

How about here - wow, her numbers suck it big time!! If you think i'm exaggerating, just take a look at today for example:

amps 354 shot 2.5
+5 346
+7 348 ...should be noted that the same droplet of blood was 299 using the ReliOn
pmps 360

I will take her to the vet this week and have her blood checked for an infection. I will also most likely ask the vet to send some blood out to see if she could possibly be an acro-cat. With the numbers in the 400's and 300's for so long, she should be losing weight - instead she is packing on the pounds and looks like 2 pounds of bologna in a 1 pound bag!!! My poor fatty.

We recenetly moved her shot time from 8am/8pm to 6/6. It's just not working!! Oddly enough, last night i was 2 hours late on the pm shot (see, it's not working) and she had the best number yet. You would think that would effect the amps but nope, right back to the usual sucky.

I am switching her back to 8 and 8. I am just confused as to how to get the best benefits of feeding. In the eve. it makes sense - she eats dinner at 5pm, gets shot at 8pm and one small can at 9pm before i go to bed. It's the morning that i'm having a hard time with. I get up and feed everyone at 6am. W (dh) gives her a shot a 8. I understand that's shooting on a food spike and the fact that she doesn't get fed again until 5 pm is not good. She's overweight as it is, should i have W give her some more food? that's not going to help with the fattness! Any suggestions?

Thanks fellow Lev users -M
 
Michele, when are her tests in relation to her shots? Is Will testing before he shoots or are you testing at 6 am and then he shoots at 8 without a test? What happens at night? I think for starters, if you are going to feed at 6/6 and shoot at 8/8, you need to test at both times so that you know is it is a food spike or not.

Those numbers are a conundrum. She seems to have gotten her best numbers at 2u, with one time at 2.25u, but never sustains them for long. The other time she got "greens" on 2.25, she dropped really low. At that point, she probably should have had a dose reduction. I really am not sure more insulin is the answer right now. But, you knew I would say that, right? She is getting some terrible numbers and I doubt they could be worse on no insulin - given she eats low carb wet food, correct? You just don't see over 400s usually with wet food. And upper 300s to upper 400s is the usual diagnoses BG. Are you testing for ketones? Has she ever had ketones?

I don't think she has acro. But I remember thinking that Beau might have acro when he was on vetsulin and I couldn't get him into decent numbers...I just know how frustrating it is to have the high numbers and to seem to have nothing work to bring them down.

The other thing to consider is that she may have insulin resistance and I think the way to deal with that is to keep RAISING until it breaks through, then be prepared to reduce the dose pretty fast. But I am not sure about that being the right way to handle it. I always read, and re-read, the pet diabetes wiki site for things like rebound and insulin resistance.

Paws crossed that you find the answer soon and she starts getting better numbers.
 
Re: Please, someone give Molly the textbook on diabetes - quickl

Michele&Molly said:
Where to start?

How about here - wow, her numbers suck it big time!! If you think i'm exaggerating, just take a look at today for example:

amps 354 shot 2.5
+5 346
+7 348 ...should be noted that the same droplet of blood was 299 using the ReliOn
pmps 360

I will take her to the vet this week and have her blood checked for an infection. I will also most likely ask the vet to send some blood out to see if she could possibly be an acro-cat. With the numbers in the 400's and 300's for so long, she should be losing weight - instead she is packing on the pounds and looks like 2 pounds of bologna in a 1 pound bag!!! My poor fatty.
Click to expand...

My guess is the vet will say you are feeding her too much. That would be what my vet would ask....that may or may not be true. Just be ready for the question on how much you feed her, and when each day, and particularly in relation to the insulin.

Michele&Molly said:
We recently moved her shot time from 8am/8pm to 6/6. It's just not working!! Oddly enough, last night i was 2 hours late on the pm shot (see, it's not working) and she had the best number yet. You would think that would effect the amps but nope, right back to the usual sucky.
Click to expand...

That is just one number....I am sorry. I just would hate to see you go back to feeding and then shooting her dose two hours after the shot before you have tried systematically to raise the dose. I know it has been hard since you can't do many spot checks during the week. But I think with these numbers you are safe to do another raise with a spot check when you can like you have been doing.

Michele&Molly said:
I am switching her back to 8 and 8. I am just confused as to how to get the best benefits of feeding. In the eve. it makes sense - she eats dinner at 5pm, gets shot at 8pm and one small can at 9pm before i go to bed.
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I don't understand why she can't wait one more hour, get fed at 6PM AND have her shot at the same time and then give her the snack at 9PM (not a small can...that is a lot of food....give her a small portion of cooked chicken breasts (it is easy...just cook up a bunch and freeze it in small portions...very low fat and pure protein).

Michele&Molly said:
It's the morning that i'm having a hard time with. I get up and feed everyone at 6am. W (dh) gives her a shot a 8. I understand that's shooting on a food spike and the fact that she doesn't get fed again until 5 pm is not good. She's overweight as it is, should i have W give her some more food? that's not going to help with the fattness! Any suggestions?
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Oh Michele, I think you are making this more complicated than it should be my friend! It is not a good idea to shoot insulin two hours after you have given a meal....that meal/glucose has sat there in her bloodstream for two whole hours without having the insulin on board to open up the cell doors so she can benefit from it. Again, the insulin is having to play catch up and this doesn't help because of her weight problem either, (sorry Molly!) insulin resistance again. And we are not talking here about overlap being able to handle the food...the insulin from the last shot is petering out by then.

Make it easy for yourself...can't you just feed her at 6AM and shoot her then? Same with the night time...feed/shoot at 6PM and then her 'snack' at 9PM?

And I think you should raise the dose again.
 
I think Pamela has studied Molly's situation better than I have (no head for details right now) and I completely agree about the feeding 2 hours early, very disruptive to how the insulin should work.

And with these numbers, she needs more insulin. Please ask the vet about getting the acro test - write down the name of it. Have the list of symptoms and basic info about acro - your vet probably won't know much (not slamming your vet, just sayin' that seems to be the experience on the board about acro cats).

Just an FYI, Gandalf was overdosed on PZI for about 3 months after diagnosis. He LOST 5 pounds in that time. No I wasn't home testing then, but I'm sure he was constantly in the 400s if not 500s from rebound. If Molly was truly being overdosed and in constant rebound or insulin resistance she surely would be losing weight, not gaining. That's my basis for suggesting you rule out acro.

Hope she doesn't have it, but I don't think it's safe to drop the dose until you rule it out, OK? I would also feel better if you'd post in the HIgh Dose group and ask some questions before you go in to ask about the test.
 
It's interesting that her numbers don't look much different on Lev than they did on PZI. And with both insulins, her numbers seem to drop more in the evening/night cycle than during the daytime cycle. So I'll agree with Pamela that you need to feed and shoot at the same time. That may take one confusing factor out of the mix. I'd also try and be a bit more systematic with the dose increases. Raise by .25 units stick with that dose for 3 days (6 shots) and raise again.

Can you remind me how much you are feeding her (and how much she currently weighs and what she should weigh based on her bone structure)?
 
I think we need to find out for sure a) what Molly weighs and b) if that is in fact a gain from some point in the near past before going down the acro road.

It's too easy to guess that a cat has gained or lost weight, but getting numbers will confirm it. For instance, Molly probably has that thick undercoat fur during the winter, maybe she has more this year because her coat is fuller over all from the early better numbers. Or from the early heavy snows and cold weather this winter... etc.

But, Michele, by all means read and ask questions over on the high dose ISG.
 
Well that's odd - i posted a pretty long message here earlier this morning and it appears to have vanished in to the air.

There's no question about it - she's fat!! Exactly 3 weeks ago she weighed 14.2. This week she weighed in at 14.5. Either way, 14lbs for a cat her size is overweight! She's a small cat.

Everyone gets fed the same amount here and yet the boys are not over weight - they look good.

I will go back to the 6 and 6 as everything Pamela (thanks again Pamela) described about insulin with food makes perfect sense. The 6 and 6 just puts an incredible strain on Will and I and our schedules.

I will be making a vet appointment this week to rule out an infection of any sort and will request and acro test - no reason not to.

Just real frustrated and I feel bad for her. I can't even image her number would be any worse with no insulin at all!!! Ugh!!
Thanks you guys for being here for us and making much needed suggestions - i appreciate it a lot.
 
If she's eating enough to make her overweight, she's also eating too much to be a healthy diabetic. Let's say she should weigh 9 lbs instead of 14. That extra 5 pounds could easily explain the problems you've had on PZI and with Lev. You may want to read Dr Lisa's webpage on feline obesity: http://www.catinfo.org/feline_obesity.htm

Cutting back on her food will improve her overall health, and will make it easier for you to manage her insulin needs.
 
Terri and Lucy said:
If she's eating enough to make her overweight, she's also eating too much to be a healthy diabetic. Let's say she should weigh 9 lbs instead of 14. That extra 5 pounds could easily explain the problems you've had on PZI and with Lev. You may want to read Dr Lisa's webpage on feline obesity: http://www.catinfo.org/feline_obesity.htm

Cutting back on her food will improve her overall health, and will make it easier for you to manage her insulin needs.
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Yes, and I agree about reading Dr. Lisa's page as well. I am not sure if you had a chance to do that before since I think around that time when it was mentioned you were pretty busy with Will's health.

And we still don't know exactly how much Molly gets each day (does she take food from the boy's dishes)? What kind of food (as in calorie content) is important too. Dr. Lisa goes into this in her obesity article.

The boys may be more active or for any number of reasons process their food differently or more efficiently than Molly. Are they the same age as Molly (who is ten).
 
Don't have any more advice at this point, but wanted to add I think it's great we're all throwing ideas out there and suggesting things based on what we see from our own experiences. We're fortunate that Michele is receptive and wants to figure this out instead of relying on any one of us to give her the answers.

Although I'm sorry Molly's case is so frustrating for Michele, this is an example of the best of FDMB.

Just doing my part as cheerleader here :RAHCAT
 
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